Individual provider Active NPI

Calvin G Jung, MD, DDS

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1093978710
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
Q6332 Issued in TX
Practice address
2024 Richmond Ave
Houston, TX 77098-4747
Phone
(832) 930-7660
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30749 TX
Surgery Physician 208600000X Q6332 TX Primary

Addresses

Primary practice location

2024 Richmond Ave
Houston, TX 77098-4747

Mailing address

2024 Richmond Ave
Houston, TX 77098-4747
Phone (832) 930-7660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30749TXMDMental Health Counselor
Q6332TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Airline Surgery Center, LLC Current Accepting new patients
Calvin Jung Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1093978710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984747",
            "telephone_number": "832-930-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984747",
            "telephone_number": "832-930-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "CALVIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "30749",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q6332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.